| NPI | 1669738605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT A CHANCY Owner 229-794-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |